Eighty-four patients with different hyperkeratinizing dermatologic disorders were treated with oral 13-cis retinoic acid (13-cis RA). The 13-cis RA increased the symptoms of blepharoconjunctivitis that were present in 17 patients prior to therapy, and blepharoconjunctivitis occurred in 17 other patients. Staph aureus was cultured from the conjunctiva of 23 patients. Treatment of the eye lids with topical erythromycin ointment enabled the patients to continue high doses of 13-cis RA. No other toxicity of the 13-cis RA was detected.